ITP血小板特异性抗体和T淋巴细胞亚群及NK细胞变化的意义探讨  

Discussion on changes in platelet specific autoantibody,T lymphocyte subsets and NK cells in patients with ITP

作　　者：冯建军[1] 杨林花[1] 陈剑芳[1] 来晓炜[1] 马艳萍[1] 马梁明[1] 侯丽虹[1] 申秀敏[1] 

机构地区：[1]山西医科大学第二医院血液科,太原030001

出　　处：《临床血液学杂志》2009年第1期27-29,32,共4页Journal of Clinical Hematology

基　　金：公益性科研专项(NO:200802031)

摘　　要：目的:检测特发性血小板减少性紫癜(ITP)患者抗血小板膜糖蛋白(GPIIb/Ⅲa、GPIb/Ⅸ)特异性抗体表达、T淋巴细胞亚群及NK细胞的变化,探讨相关因素在ITP发病机制中的作用。方法:应用改良血小板抗原单克隆抗体固相化检测技术(MAIPA)、流式细胞术分别检测52例ITP和24例正常对照组抗血小板膜糖蛋白(GPIIb/Ⅲa、GPIb/Ⅸ)特异性抗体表达、T淋巴细胞亚群及NK细胞变化。结果:ITP组的血小板计数明显低于正常对照组(P<0.05);抗GPⅡb/Ⅲa及GPIb/Ⅸ抗体A值均高于正常对照组(P<0.05);相关分析表明ITP组血小板计数与两种特异性抗体水平均呈负相关关系;在T淋巴细胞亚群变化中,ITP组CD3+T淋巴细胞百分比、CD4+T淋巴细胞百分比及CD4+/CD8+的比值均明显低于正常对照组(P<0.05),CD8+T淋巴细胞百分比则显著高于正常对照组(P<0.05);NK细胞百分比明显低于正常对照组(P<0.05)。结论:血小板特异性抗体及T淋巴细胞亚群的变化可较好地反映ITP这一病理过程,对提高诊断水平及指导临床有一定的实用价值。Objective： To test the expression of anti-GPⅡb/Ⅲa and anti-GPⅠb/Ⅸ specific autoantibodies and changes in T lymphocyte subsets and NK cells in patients with ITP and to discuss the related factors envolved in pathogenesis of ITP. Method：Expression of anti-GPⅡb/Ⅲ a and anti GPⅠb/Ⅸ specific autoantibodies and changes in T lymphocyte subsets and NK cells in 52 patients with ITP and 24 healthy controls were tested by monoclonal antibody immobilization of platelet antigens assay （modified MAIPA） and flow cytometry respectively. Result： Platelet count in patients with ITP was much less than that in healthy controls （P〈0.05） ; optical density （A） of anti-GPⅡb/Ⅲa and anti-GPⅠb/Ⅸ autoantibodies was much higher than that in healthy controls （P〈0. 05）; there was a inverse correlation between the platelet count and the expression of each autoantibody in ITP patients;in terms of changes in T lymphocyte subsets, the percentage of CD3^＋ T Lymphocyte and CD4^＋ T Lymphocyte and the ratio of CD4^＋/CD8^＋ in patients with ITP were obviously lower than those in healthy controls （P〈0.05）, but the percentage of CD8^＋ T Lymphocyte was much higher （P〈0. 05） ;the percentage of NK cells was significantly lower than that in healthy controls （P〈0. 05）. Conclusion： Expression of platelet glycoprotein-specific autoantibodies and changes in T lymphocyte subsets can reflect the pathogenesis of ITP well. What＇s more, the test of them has a certain practical value in improving the diagnosis of ITP and guiding clinic.

关 键 词：紫癜 血小板减少性 血小板特异性抗体 T淋巴细胞亚群 NK细胞 

分 类 号：R554.6[医药卫生—血液循环系统疾病]